Silverado Building Hospice Into Stronger Operational Tentpole

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Silverado hosted a belated opening celebration for its new hospice in the Chicago suburb of Des Plaines, Illinois on Wednesday, Oct. 10. The facility quietly opened in February. Silverado also opened a hospice serving the Dallas/Ft. Worth area in Addison, Texas last month.

The total number of hospices under the Silverado umbrella is now at 11. This helps fulfill the Irvine, California-based company’s goal of opening two hospice sites a year over the next five years, while continuing its overarching mission of providing quality of life to their residents and clients in senior living, memory care and home health care, and their families. Hospice care has become a tentpole in Silverado’s operations.

Hospice currently accounts for 20% of Silverado’s total revenue and it will play an important part in Silverado’s growth strategy, president and CEO Loren Shook told Senior Housing News. He called hospice a wonderful tool to improve the quality of life of patients in their final days, regardless of their station in life. For most Silverado residents, hospice care is an extension of an existing relationship.

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“We take care of people in our memory care communities through the end of life,” Shook said. “Eighty-six percent of people in our communities pass away on hospice care. It is important for their quality of life to be on hospice, to avoid needless trips to the emergency room, and we provide the advantage of guided medicine services and grieving services.”

Silverado CEO Loren Shook

Silverado’s Chicago facility is an outlier in its portfolio. While the other hospices were ground up developments, Silverado took over a pre-existing, licensed hospice.

Silverado’s hospices offer care in home, at a hospital or at assisted living communities, with a staff trained to treat people suffering from Alzheimer’s, Lewy body, Parkinson’s or other types of dementia. The hospices offer alternative therapies such as music and pet therapy, and have an essential oils aromatherapy program which is believed to be a safe, natural way to calm and soothe patients, and increase circulation, while helping to reduce the usage of certain medications.

Hospice is only a part of Silverado’s future growth strategy. The company opened its first East Coast assisted living and memory care community in Alexandria, Virginia, and another community in St. Charles, Illinois this week, Shook said. Silverado is providing hospice care to the homeless through its San Diego hospice, and is sending a team to Armenia in a couple weeks to educate groups on hospice care.

“It’s 10 times the work, but that’s what we’ll do for you to be good community partners,” Shook said.

Hospice’s growing role in health care

Hospice is taking on a larger role in the health care continuum, and senior living providers are taking notice.

The trend is being driven by health systems and payers like Medicare Advantage. They are pushing for more care coordination, from acute care to post-acute services and the end of life, as a means to keep hospital visits — and costs — down, while maintaining good patient satisfaction and outcomes.

Major health insurer Humana (NYSE: HUM) acquired a stake in hospice provider Curo Health Services earlier this year in a $1.4 billion transaction. Louisville-based Humana is betting that it can better serve its large Medicare Advantage population by having these in-house hospice services, even though hospice itself is not an allowable benefit under MA. There is chatter that it hospice will eventually become an MA benefit.

Just last week, Baton Rouge, Louisiana-based Amedisys Inc. (Nasdaq: AMED) acquired Compassionate Care Hospice for $340 million. Led by former Humana executive Paul Kusserow, Amedisys, one of the largest Medicare-certified home health providers in the nation, believes that it will be a more attractive partner to MA and managed care plans by offering the full range of in-home services, from personal care to skilled home health and hospice. The general idea is that health plans and managed care groups want to work with the providers who have the scale and sophistication to serve large populations of older adults.

Senior living providers like Silverado also see opportunity here. For instance, Silverado’s 86% utilization rate for hospice is advantageous for reducing unnecessary, costly medical interventions at the end of life. Such interventions often don’t extend someone’s life and more often have a negative impact on quality of life.

Silverado is not alone in looking to expand its hospice practice. Brookdale Senior Living CEO Cindy Baier cited hospice as an area of growth, as the company looks to rebound after several troubled years.

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Always inquisitive and often curmudgeonly, Chuck can often be found on a bike unlocking Chicago's secrets, telling stories, making cocktails, checking out live music, tearing through his podcast and Filmstruck queues and playing with his pitbull, Mira.

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